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Developmental Dysplasia of the Hip (DDH) is a spectrum of disorders involving abnormal development of the hip joint, where the femoral head and acetabulum are not properly aligned.
📌 Definition
DDH ranges from:
Mild acetabular dysplasia (shallow socket)
Subluxation (partial displacement)
Dislocation (complete displacement of femoral head)
👶 Risk Factors
Female sex (more common)
First-born child
Breech presentation
Family history
Oligohydramnios
Tight swaddling practices
🔍 Clinical Features
In Infants (<6 months)
Barlow test → dislocates unstable hip
Ortolani test → reduces dislocated hip (clunk felt)
Limited hip abduction
Asymmetrical thigh/gluteal folds
In Older Infants (>6 months)
Limb shortening (Galeazzi sign)
Reduced abduction
Delayed walking
In Walking Child
Limping or waddling gait
Trendelenburg gait (bilateral cases)
🧪 Investigations
Ultrasound (best in infants <6 months)
X-ray pelvis (after 6 months)
⚕️ Management
Birth – 6 months
Pavlik harness (first-line)
6 – 18 months
Closed reduction + hip spica
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